Expert: Dr. J. Shawn Leatherman - 1/16/2009

Question
I have had pain in my pelvic bone since right after the birth of my child 7 yrs ago. Right after I was hurt in a domestic violence problem. His knee went right into the front of my pelvic bone with all his weight. It has hurt ever since. Some days I can't walk. The pain comes and goes in severity.. but the stability is gone. Shortly later my Low back started hurting and it still does very much! Nobody pays it any attention, just blows it off..  My chiropractor says due to diet. of course, I haven't told him the above statement. Just know I sick and tired of being in pain.  Thanks

Answer
Dear Kim,

The first thing you need to do is be open and honest with the chiropractic physician whom you are treating with.  The fact that he does not know your health history concerning the trauma can be misleading his diagnostic skills.  You should always be open and honest with all of your doctors as much of the diagnostic criteria is comprised of the patient history, and this helps to guide the examination process.

Now, at this point, I absolutely do not think that this is related to your diet...the pregnancy places increased stress on the joint at the front of the pelvis and a hormone called Relaxin is released, which allows the pelvic structures to become more flexible. (Sacroilliac joints at the back of the pelvis and the symphysis pubis joint at the front of the pelvis).  Then you sustained a direct trauma to the joint while your pelvis was still in that relaxed state, which means that it may take less force to create an injury because you had compromised stability.  I would recommend that your chiropractor specifically adjust the anterior pelvic joint first and then the SI joints if needed.  

There is a disk-like structure in the symphysis pubis joint which is comprised of a tough fibro-cartilage adjoins both sides of the pelvis bones.  This disk is probably chronically inflamed due to continued stress on the joint due to joint restriction.  It is more likely that the joint is restricted rather than lax, and adjusting the pelvic structures should alleviate tension and stress on the associated joint structures.

Symphysis Pubis:  This adjustment is performed with the woman flat on her back with her hips bent at 45 degrees and the knees at 90 degrees.  It is a light force adjustment that allows the pubic joint at the front of the pelvis to remain unrestricted.  Often utilized on pregnant patients as it allows for an easier delivery. Also the doctors hand placement is not compromising for the woman, the doctors hands are at the knees for this adjustment, not in the pelvis.

Many chiropractic physicians are not trained in this type of adjustment, so it is important to ask about advanced training they may have received...make them explain it to you.  If they can't explain it to you, get another chiropractor who can concerning pregnancy.  Look for chiropractors who have advanced training in cranio-sacral therapy, pediatrics, or fascial unwinding.  Chiropractors that have been trained by Dr. Carol Phillips or Dr. Upledger are good choices.

After you have been adjusted this way approximately 3-5 times, you should see significant improvement, which should be followed up with resistance exercises that involve the musculature inside of the legs that attach to the pelvis.  This will help to stabilize the area and create strength.  Make sure you do not push on these exercises too hard...utilize gentle resistance, and give yourself a few weeks before you start this.  Your chiropractor should be able to guide you through this process.

Hope this helps Kim.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasathealthcare.net